In Guatemala City, health care workers went at least 40 days without pay. In Honduras, hospital cleaners are clearing out hospital rooms with their bare hands. In the US, health care workers have been fired for demanding safe working conditions. 

Nowhere else in the world has been hit harder by the COVID-19 coronavirus pandemic than the Americas, yet the region has largely failed to support and protect health care workers, according to a new report published Tuesday by Amnesty International.

Health care workers in the region have been denied safe working conditions, personal protective equipment (PPE), and reasonable break times and pay, the report says. They have been subjected to violence, harassment, and stigma, and have had to go on strike in the midst of a pandemic. 

Countries throughout the region have failed to abide by international human rights and labor standards during the pandemic, according to Amnesty International, exposing a governance crisis that goes far deeper COVID-19. 

The report is ultimately a call to action, urging leaders throughout the Americas to step up and support health care workers, while also collaborating throughout the region to stop the pandemic. 

“We hope that people can stop seeing health workers as just heroes and start seeing them as humans that need protection at work like anyone else who goes to work and needs protection,” Madeleine Penman, regional researcher in the Americas for Amnesty International, told Global Citizen. “It’s time to stop only saying thank you to health care workers and to make commitments to changing the situation so they never have to face these terrible risks again.”

The report features various anecdotes and incidents of health care workers facing challenges and abuses at work. The most glaring issue involves the widespread lack of PPE that puts health care workers at risk and forces them to work in grueling conditions. 

The report notes how Nicaragua took weeks to disburse critical PPE to hospitals and Haiti showed a glaring lack of supplies a year before the current outbreak. In Guatemala City, doctors have had to use plastic bags to cover their faces and hands, while doctors in Mexico City and Paraguay said that they were denied water and bathroom breaks throughout their shifts because it would mean they would need more PPE. 

Amnesty International reports that cleaners and housekeepers face the most egregious lack of equipment in the region, a trend that has been extensively documented. Cleaning services are often contracted out to third parties that sometimes fail to abide by labor and human rights standards. 

“They’re definitely the most vulnerable, underpaid part of the sector,” Penman said. “They’re very vital, but they’re the ones being overlooked. They’re often not included in the training sessions or the information sessions to other employees — they’re just sort of completely ignored.”

Health care workers often face repercussions, professional and otherwise, when they speak out and demand fair and safe working conditions, according to the report. 

The report recounts a number of examples. 

A 70-year-old cleaner in Mexico City was docked pay after requesting to clean only administrative areas because his age put him at heightened risk of infection and he lacked PPE. In the US, a health care worker at a nursing home was fired when she posted a video detailing the lack of PPE in the facility. In Nicaragua, there have been numerous cases of doctors and nurses fired after speaking up, and Brazil’s health minister was fired after criticizing the country’s response to the pandemic, the report says. 

Health care workers have also been repeatedly attacked throughout the region. In Bolivia, buses carrying health care workers were pelted with stones, while doctors in Colombia have received death threats. 

These threats are often fanned by world leaders who, according to Amnesty International, either stay silent in the face of this violence or sometimes even tacitly endorse it.

For example, Nayib Bukele, the president of El Salvador, condemned human rights organizations in a series of statements, undermining their work. 

In other cases, however, world leaders have stood up for health care workers, deterring violence in the process. Mexican President Andrés Manuel López Obrador has consistently thrown his support behind health care workers in Mexico following a series of attacks on doctors and nurses. 

Amnesty International’s report is framed by two international human rights and labor treaties — the Convention on the Elimination of All Forms of Racial Discrimination and the International Covenant on Economic and Social Rights (ICESCR) — that governments throughout the region have signed and incorporated into their laws. 

“It’s important to highlight [these treaties] because countries are actually violating their own laws,” Penman said. “They need to recognize this pandemic is not just an unfortunate occurrence that they cannot be held responsible for; history will not judge kindly those countries that didn’t do enough to implement measures to protect the over 9 million health care workers in the region.”

Amnesty International is calling on countries throughout the Americas to adopt various measures to support and protect health care workers. 

Countries can immediately pass legislation to pass health workers rights to fair and safe working conditions, protect whistleblowers, and direct resources to cleaners and housekeepers. Governments can conduct independent audits of health care facilities, prevent the harassment and violence, and go out of their way to recognize the sacrifices of health care workers. 

Amnesty International also calls on countries with more resources to contribute to low-income countries.

“We’re seeing that Latin America is in the deadliest clutches right now of this virus, and any move from wealthier nations to turn their back on their southern neighbors is unconscionable,” Penman said. 

“Immediate action needs to be taken with laws to ensure that protective personal equipment is arriving, but we’re also calling for countries in the Americas to work together. They need to figure out which countries need help, which have problems and resources. This isn’t a time for politics; it's a time for governments to figure things out together,” she said.  

Some recommendations are meant solely for the United States. In recent weeks, President Donald Trump has vowed to withdraw funds from the World Health Organization. The report urges the US to maintain and increase funding to the WHO and other UN agencies fighting COVID-19. 

“The reason why we’re launching this report contemporaneously is to draw attention to the grave actions taken by the US to disregard the necessity of funding to global health efforts,” Penman said. “The announcement by Trump that he wishes to withdraw money from the WHO flies in the face of everything that’s needed at this moment.”

Penman said that the report is just a starting point. It’s part of Amnesty International’s broader #PromiseToCare campaign that seeks to rally public support for health care workers around the world. You can take the pledge here. 

“We all promise and pledge together that these violations of workers rights will not happen again,” Penman said. “We’re hoping it’s something that spreads like wildfire.”